A multidisciplinary team of collaborators from academic institutions and communities in Appalachian regions of Kentucky, West Virginia, Ohio, Pennsylvania, New York, Maryland and Virginia are proposing to build on a strong foundation of previous activity of the Appalachia Cancer Network (ACN), an NCI-funded Special Populations Network, and develop the Appalachia Community Cancer Network (ACCN). The proposed ACCN will expand the previous ACN and expand to address cancer health disparities in seven areas in Appalachia, areas that include some of the most medically underserved, distressed, and economically disadvantaged areas in the US. Cancer mortality rates are elevated in each of these areas, as are the incidence rates for lung, cervical and colorectal cancers, suggesting that factors such as late stage diagnosis and barriers to cancer care must be addressed if disparities are to be reduced. The long-term goal of the ACCN is to contribute to the reduction of cancer health disparities in Appalachia by developing, implementing and evaluating community-based participatory research and providing training. The specific aims of the AACN are to: 1) Build on a foundation established by the ACCN and develop and maintain community partnerships to facilitate research and action to reduce cancer health disparities;2) Conduct community based participatory research ranging from focused needs assessments to intervention research to policy assessments;3) Develop pilot research projects that focus on primary and secondary prevention of lung, cervical and colorectal cancers in Appalachia;4) Train researchers in community-based participatory research;and 5) Conduct evaluation of the ACCN, including attention to processes, short term impact, and achievement of outcomes. The ACCN will build on the ACN and develop programs in cancer education;community based participatory research, and training. Proposals for two pilot projects are also included. The pilot projects address cervical and colorectal cancer, two cancers targeted by the ACCN